| NPI | 1144683608 |
|---|---|
| Former Name | ALYSSA NICHOLE BROKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR0062135) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-05-15 |